Peer Support and Building an Infrastructure of Employee Mental Wellness

00;00;00;26 - 00;00;18;18
Tom Haederle
For many clinicians, the pressure of treating a never ending line of patients, always moving on to the next one and the next one can make even the most dedicated healers wonder if they're up to the rigors of the job. There is a term for this, second victim syndrome acknowledges the toll that giving care can take on care providers.

00;00;18;21 - 00;00;37;22
Tom Haederle
For decades, the code of conduct was understood to be swallow hard and get back to work. Soldier on. But the COVID pandemic has been a cultural game changer. Its lasting effect on the care teams that fought so valiantly to treat a tidal wave of very sick patients meant that we had to start talking about issues like burnout and addressing well-being.

00;00;37;24 - 00;00;57;11
Tom Haederle
One result of the pandemic experience has been an increase in the number of hospitals and health systems that now employ chief wellness officers, a trend that is growing.

00;00;57;13 - 00;01;21;22
Tom Haederle
Welcome to Advancing Health, a podcast from the American Hospital Association. I'm Tom Haederle with AHA Communications. In recent years, the idea that caregivers themselves need ways to deal with the stress and exhaustion of the job has taken root and spread throughout our health care system. In this podcast, one physician who began as an E.R. doc describes her journey to a chief wellness officer with a major health system today.

00;01;21;24 - 00;01;29;29
Tom Haederle
As she says, "in ten years, chief wellness officer will be as common as having a chief of anything else." Let's listen in.

00;01;30;02 - 00;01;54;05
Elisa Arespacochaga
Thanks, Tom. I'm Elisa Arespacochaga, vice president of Clinical Affairs and Workforce. And today I'm really pleased to be joined by Dr. Suzanne Bentley, chief wellness Officer, director of Simulation, Innovation and Research and attending physician at the New York City Health and Hospitals in Elmhurst. Today, we're talking about her journey in leading and participating in organizational-wide wellness programs and the great work that she's been able to do there.

00;01;54;06 - 00;02;01;08
Elisa Arespacochaga
So, Dr. Bentley, to get us started, can you tell me a little bit about yourself and your role at New York City Health and Hospitals?

00;02;01;10 - 00;02;21;27
Suzanne Bentley, M.D.
Sure. Thanks so much for having me today. I'm really honored and excited to be here with you, as you mentioned. So I'm Suzy Bentley. I'm the chief wellness officer at Elmhurst. Important perhaps to point out I'm actually the first chief wellness officer at a New York City Health and Hospitals site. So we have 11 acute care hospitals and we have a wonderful systemwide chief wellness officer.

00;02;22;00 - 00;02;44;02
Suzanne Bentley, M.D.
But I am the first and perhaps the pilot, which is going well. So hopefully there will now be more but out of sight. So it's really been an adventure because it's been a bit of an unprecedented role that has definitely evolved over the last year and a half. As you mentioned, I have several other hats at Elmhurst and some could look at my career and it's kind of bobbed and weaved and evolved.

00;02;44;02 - 00;03;04;08
Suzanne Bentley, M.D.
But I think debriefing has really been kind of the grand unifier in all of the professional roles, both as an educator in residency leadership, doing simulation and then obviously now through wellness. And it's just been absolutely wonderful and very, very worthwhile position to now be in.

00;03;04;10 - 00;03;32;29
Elisa Arespacochaga
Sounds awesome. Well, to get us started, you started in this this wellness journey, and I know you've had a bunch of different things that you've brought to this. As you started to lay out the work to be done, particularly having a system level effort and now you're bringing it to the local site. What helped you really think through and refine what your messaging was, how you asked your colleagues and others in leadership to support the work you were doing and and really help you get launched in this work?

00;03;33;01 - 00;03;56;27
Suzanne Bentley, M.D.
So I'd say that my journey with workforce wellness really started probably informally as a resident. I think, as I was struggling -so I'm an emergency medicine physician, as was mentioned - as I was struggling with processing a lot of hard cases and learning really how to handle some of the emotional struggles as well as frustrations that can come with delivering health care or even probably some degree of burnout of my own.

00;03;57;02 - 00;04;24;17
Suzanne Bentley, M.D.
I really felt compelled to try to encourage people to talk about cases at a time culturally where nobody was really talking about things. You just kind of swallowed hard and went back to work. And I really was left even at certain times, wondering if I was strong enough to do emergency medicine because it just never totally sat right that you could take care of such critical cases and human lives and then just move on to the next no matter the outcome.

00;04;24;22 - 00;04;55;26
Suzanne Bentley, M.D.
And I think that's where I got curious about how we could do it differently. Then Dr. Eric Wei, one of my colleagues at Health and Hospitals, introduced Helping Healers Heal, which is a peer support program. And this was back in 2017. And I first learned through that about the concept of second victim syndrome, which was really interesting to me because that was now a formal clinical term, acknowledging the toll that health care delivery takes on the caregivers, really with us being the second victims at times.

00;04;55;28 - 00;05;23;25
Suzanne Bentley, M.D.
And I just felt such a pull to serve to get more involved and saw that as how we might be able to change the culture of how we look at wellness. So a lot of the initial work I did was through running Helping Healers Heal at Elmhurst. And I'd say the messaging then was really just trying to get people to acknowledge that things needed to be talked about, that that wellness needed to be talked about for the actual humans doing the health care themselves.

00;05;23;27 - 00;05;46;24
Suzanne Bentley, M.D.
You know, a lot around just it's okay to not be okay. This is hard for everybody, kind of no matter how they're acting and really working through a lot of the stigma that I think is present at all levels in healthcare. Definitely, definitely with physicians. And then COVID happened. And as I'm sure you are aware, Elmhurst was just absolutely devastated, like so many institutions across the globe.

00;05;46;27 - 00;06;08;17
Suzanne Bentley, M.D.
But having such a marginalized population being hit first in New York City, it really just devastated everyone. And suddenly it was almost weird and not okay if you walked around like you were fine. If your answer to how are you is I'm good, I'm okay. You know, that was really a red flag. And denial only gets you so far.

00;06;08;20 - 00;06;32;18
Suzanne Bentley, M.D.
So I think the gray linings, it wasn't quite silver, but for COVID was this amazing ground level and vulnerability that suddenly people wouldn't run away from me When I tried to introduce discussions around how we could support staff, how we could do it differently because everyone was struggling and everyone suddenly almost became desperate, almost survival really, for those delivering the care to how we could get through it together.

00;06;32;21 - 00;06;53;16
Suzanne Bentley, M.D.
And I think that is how really right coming off of the pandemic from doing so much programing both at Elmhurst as well as for health and hospitals. With many of my colleagues, we were able to start talking about should we have chief wellness officers. This is very clearly a gold standard role that is in a lot of places, but not everywhere.

00;06;53;18 - 00;07;13;11
Suzanne Bentley, M.D.
And I think in ten years will be as common as having a chief anything else. But that kind of set the stage, I think, for a lot of people to be very open to what this role could be and how we could start to look from an organizational lens of how we could support staff, how we could show up differently for staff.

00;07;13;14 - 00;07;34;15
Suzanne Bentley, M.D.
So I think the messaging really went from one of let's talk about how you feel, because we have to do that or we're not going to stay strong and be able to do this for forever, you know, for our whole careers, really, to one of how are we going to stay strong together? How are we going to put things in place so that we don't have to pick up the pieces quite as much?

00;07;34;15 - 00;07;57;04
Suzanne Bentley, M.D.
We can actually kind of get ahead of a lot of this. And then also into much more robust discussions too, around, you know, how are we measuring this? How are we even staying on top of how our staff are doing, which I think is kind of an ongoing debate that we have in the in the wellness realm around meaningful metrics and then kind of, you know, how to do informed programs.

00;07;57;06 - 00;08;08;08
Suzanne Bentley, M.D.
So so it's really, really evolved in a very, very cool way, as well as perhaps overwhelming an all encompassing way because there's just so much work to be done.

00;08;08;10 - 00;08;27;23
Elisa Arespacochaga
That is awesome. I can only imagine, and having talked to many of your colleagues in New York City, the impact that COVID had to really push everyone to this point of understanding that not only am I not, don't think I'm okay, everybody's not okay, and we all need to talk about it if we're going to get to the other side.

00;08;27;25 - 00;09;06;08
Elisa Arespacochaga
While I don't love the method that got you there, I'm glad it got you to that conversation. Let's talk a little bit about some of the work that I know you've done a lot on in pulling this all together is you've really tied a lot of the wellbeing work to your roots, I would say, in quality and patient safety. And really done a lot to use that structure that you built and the entire field has built to make sure that we are staying true to our mission and vision related to quality and patient safety and using some of the measurement and metrics and structures to really help address wellbeing as well.

00;09;06;08 - 00;09;08;13
Elisa Arespacochaga
So I'd love to hear about how you're doing that.

00;09;08;16 - 00;09;30;20
Suzanne Bentley, M.D.
That is such a great and very powerful question and one that, you know, sometimes makes me chuckle because I work so closely with so many of our amazing behavioral health colleagues, many of whom I started helping healers deal with. And I was routinely asked initially, so are you a psychologist? Nope. sure you are. You're a psychiatrist?

00;09;30;22 - 00;09;52;17
Suzanne Bentley, M.D.
No. So what are you? And I would say, you know, I'm actually an emergency medicine doctor. And they would look at me like it made no sense. How are you? How are you getting through to people? How are you changing their well-being? And that really was a gateway to talking about, you know, what wellness is and how we get there.

00;09;52;17 - 00;10;32;26
Suzanne Bentley, M.D.
And I sometimes joke through peer support with my colleagues in behavioral health that it is not therapy, which is very, very different in that respect and is not something I'm trained to do. But definitely gets into therapeutic conversations for sure. But that, you know, and the same like yoga and meditation. I've gotten very good at leading those. But really when we look at well-being of our workforce, at the end of the day, how we're going to move the needle at the end of the day, for me, it really has to come down to systems and I think it has to come down to the rigor that we have always applied when we look at quality

00;10;32;26 - 00;10;59;12
Suzanne Bentley, M.D.
and safety. And I come from a change management background, I come from a systems improvement background, and I think that's how I ended up in the role and was positioned to to really start those conversations. I think 99% of quality and safety in most places when you say those words, that that still implies quality of care for patients as it should, and patient safety.

00;10;59;14 - 00;11;24;01
Suzanne Bentley, M.D.
You know, when you hear safety, most people are not thinking staff safety because what is staff safety even mean? At the end of the day, we all are in this and we all show up every single day to do the best care, right, and show up the best we can for the patients. How we get the staff to a place where they can do the high quality care, how we get the staff to a place where they're safe so they can be more compassionate, so that they can make less errors, that a patients can be safer.

00;11;24;03 - 00;11;45;11
Suzanne Bentley, M.D.
And I think the alignment working with so many people in quality and safety in PI, just across the board and kind of merging all of those worlds and trying to share meaningful metrics, trying to look at what are we already collecting that's patient facing that really we could be collecting also that staff facing. And why aren't we doing that?

00;11;45;15 - 00;12;05;28
Suzanne Bentley, M.D.
And a lot of the answer is because it just isn't what we're doing, because no one's ever said we should be doing that. So trying to really define what are those metrics, right? There's great survey-based assessments that are being done. And I'm so grateful to the leaders in the realms, you know, writing them. And a lot of our data for well-being is around that.

00;12;06;04 - 00;12;35;26
Suzanne Bentley, M.D.
But also, how do you add the perspective of speaking up? How do you take your incident reporting portal and look, if you have enough good catches. Are the staff putting in all the things that are near-misses or where they went wrong? And that speaks to the psychological safety of the staff, that speaks to how you as an institution are developing a culture that empowers the staff to feel that you want to hear them, right, and that you're acknowledging that it's all about the system.

00;12;35;29 - 00;12;53;16
Suzanne Bentley, M.D.
At the end of the day, I think we all know whether we admit it or not, and I think more and more people are admitting it. It's never coming down to one final thing that happens, you know, at the bedside. So many things have led up to that and kind of how do we improve all of those systems?

00;12;53;18 - 00;13;16;07
Suzanne Bentley, M.D.
And another corollary to that is really with debriefing, I feel very strongly, you know, there's emotional support debriefing, there's clinical debriefing. I don't think you can really divorce them. I think when we say, you know, we're here to have a safe conversation, we're here to have a brief conversation, there's no agenda. What do you need? Some staff, they don't want to talk about how they feel.

00;13;16;15 - 00;13;38;18
Suzanne Bentley, M.D.
They want to ruminate on the medicine. They want to tell you the what ifs, because that's how they're processing. And they want to tell you everything wrong with the hospital, everything wrong with the leadership, everything wrong from their perspectives. And I really think we need to see those as their hard won ideas. You know, they're on the frontline doing the care, coming up with those ideas.

00;13;38;18 - 00;14;11;08
Suzanne Bentley, M.D.
And I think the way they heal is from having a place to put those ideas, to know that they're getting to someone that can take them, take it or leave it, but at least know about them. And then the flip side is some people don't want to talk about the medicine or they're not really able to process or to talk about quality or improvement until they're able to acknowledge how devastated they are about the outcome, whether it was a totally foreseen conclusion at the door, which in the E.R., many times the cases are.

00;14;11;16 - 00;14;39;29
Suzanne Bentley, M.D.
But if you can't safely clear the emotion and be vulnerable, I think you get a lot less ability to then get into the safety and the quality and how you fix things. So I think a lot of this for me is kind of marrying all of those worlds and just setting up infrastructure so that whatever you're taking in from people, especially if it's from a conversation that perhaps is with a bit of pain behind it, like most of COVID was, you know, how were we escalating those ideas?

00;14;39;29 - 00;14;45;14
Suzanne Bentley, M.D.
How are we capturing them? How are we actually making things better? Because that's how we'll make the staff more well.

00;14;45;16 - 00;15;05;01
Elisa Arespacochaga
Yeah, no, I think that's a really important point, is that you have to give people a couple of different doors to come through to understand how they can best process this. Nobody will work through it the same way. And for some it's all about, okay, what went wrong? I need to analyze and take it apart. And for some it very much is

00;15;05;03 - 00;15;25;05
Elisa Arespacochaga
I can't deal with this until I deal with the fact that this just happened in my presence. I love that your offering them, you know, offering your team all of those different approaches and especially love the piece about asking the people who are on the front lines doing the work, what is it that we can fix? They know the work better than anybody.

00;15;25;08 - 00;15;46;05
Elisa Arespacochaga
So as you look back at COVID and all the work that you've done up to this point, what are a couple of key, whether it's resources or initiatives or efforts that you would have that you'd consider absolutely essential to your success, that if you had to pick up and go somewhere else, you'd say, I can't do it without X, Y and Z.

00;15;46;07 - 00;16;10;22
Suzanne Bentley, M.D.
I think that the key one, like so many things in life, is it really comes down to the most crucial resource, which is people and having the right people. And that's everything from the right stakeholders that really get it, you know, and perhaps can perpetuate the buy in to having a team. And great example is Helping Healers Heal is our peer support program.

00;16;10;22 - 00;16;39;21
Suzanne Bentley, M.D.
When it started, including for myself, it was 100% volunteer. So we had trained peers that would show up to debrief or to support other staff again, but they were volunteering. So it was during their work day. But really, who has time to take on anything, no matter the dedication and the intentions? And I think - what I know now is how much more we could have done if we had dedicated, you know, actual set staff with protective time to do it.

00;16;39;23 - 00;17;07;06
Suzanne Bentley, M.D.
And then now being in this role, now having not many but several full time dedicated workforce wellness staff, I think that has been kind of just the exponential multiplier in our success of being able to reach people. And additionally, I think optics are important and I think that when you pay people to do a job, it speaks volumes to the staff that it's not flavor of the day, it's not going anywhere.

00;17;07;12 - 00;17;32;08
Suzanne Bentley, M.D.
You actually are so invested that your money is where your mouth is. You've hired people to do this work because they matter that much. I think it's not huge amounts of people, although we could definitely use a bigger team and we will get there. But I think just dedicated staff that are paid and don't have split attention and split focus has been probably the biggest lesson learned and the biggest resource.

00;17;32;10 - 00;18;06;18
Suzanne Bentley, M.D.
And along the lines with people, I would say really finding mentors and advisors and just tapping into people to ask questions. The biggest thing is again, time is so precious, is really not reinventing the wheel. And if I've learned nothing through quality and safety work, every great idea has been tried in some capacity. So if you start at why didn't it work when we did it the other 42 times, you know, often you can start 100 steps ahead, then just starting completely over.

00;18;06;18 - 00;18;47;00
Suzanne Bentley, M.D.
So the charm Network of Chief Wellness Officers has been an amazing resource for me. I'm very, very blessed. I've worked with Dr. John Ripp, who's the CWO at Mount Sinai for a number of years, actually in a global health capacity. But he's really become a mentor. And when I have questions, I need resources, instead of having to spend days and hours hunting knowing I have this infrastructure, I can reach out to people, you know, has really, really been paramount. And collaborating because we all, I think, have very, very similar pain points and struggles and and sharing ideas both fixes problems as well as I think just continues to pick us all up that are doing

00;18;47;00 - 00;19;08;15
Suzanne Bentley, M.D.
the work and keep the inspiration going on why it matters and reminding all of us how far we've come. And that - and I would really say - that it sounds silly to say as a resource, perhaps, but but social capital has been a big one. I think doing this role somewhere that I trained as a resident and I never left and I've been in lots of different roles.

00;19;08;18 - 00;19;40;24
Suzanne Bentley, M.D.
I know a lot of people and I, you know, I joke I was raised by the nurses in the emergency department who I'm still very close with. I think having relationships well-established from the front line where I work all the way through to executive leadership has helped really make gains much more quickly than if I came in not knowing anyone and having to just pitch everything and prove everything that much harder, kind of, you know, the street cred alone, just of working on the front line, having walk the walk.

00;19;40;26 - 00;19;59;05
Suzanne Bentley, M.D.
I think, you know, it speaks volumes compared to just trying to say, you know, I see you. It's a little bit different when it's, I see you and I've been in that situation and yeah, it was a little different. But like, I'm on the other side and, you know, let's take my hand, let's collaborate. We're going to do it together.

00;19;59;07 - 00;20;06;01
Suzanne Bentley, M.D.
Has really, I think, again, helped kind of just expedite how quickly we move forward with putting a lot of different things into place.

00;20;06;04 - 00;20;33;23
Elisa Arespacochaga
Yeah, no, I can't imagine the amount of ability you have to move things forward just because you do know who the people are, who you need to have on your side and on your team, and who those sort of informal leaders are that need to be part of your crew too, to really advance something. That's great. I think that's another great example of of the both intangible and tangible efforts you need to put into this work.

00;20;33;26 - 00;20;44;00
Elisa Arespacochaga
So can you tell me a little bit about, you know, sort of the biggest hurdle you've faced thus far and how much was it one that you saw coming or maybe not saw coming?

00;20;44;02 - 00;21;09;17
Suzanne Bentley, M.D.
I think the biggest hurdle has been getting over this compulsion to try to boil the ocean. I think this role is so high stakes and I believe in it so strongly, like everyone that's doing this work, that especially in the beginning, it almost felt like like a frantic piece of meeting to try to do all the things for everyone all at once.

00;21;09;17 - 00;21;33;25
Suzanne Bentley, M.D.
And luckily I took a step back after a few weeks of that and realized, number one, it wasn't sustainable. And number two, like doing everything 75% of the way was never the way to grow a program. I think that one of the biggest hurdles has really been the lack of boundaries, I guess for for lack of a better word, on what workforce wellness is.

00;21;33;28 - 00;22;10;11
Suzanne Bentley, M.D.
And it's kind of twofold because it's everything, right? Because wellbeing is truly a very personal thing and what affects you might be different than me, different than the next person. And because of that, I think that it is can become everything to everyone. And I had to very intentionally kind of set some boundaries also so I didn't get eaten alive by the requests and the job, and I still could carve out time to be intentional again at how are we looking at this from the organizational lens

00;22;10;14 - 00;22;44;14
Suzanne Bentley, M.D.
not the individual, just the individual piece. And part of that was figuring out not how to deflect, but how to collaborate, perhaps. Because certain things there...and this is h.r. And I have amazing collaborators now with h.r. You know, and we've learned a lot together. I think when you offer staff a confidential forum and they feel safe coming and sharing that sometimes they may want to share with you because they don't want something documented, and that's okay as long as they're safe and it doesn't need to be documented.

00;22;44;14 - 00;23;04;02
Suzanne Bentley, M.D.
Right. You know, within the limits of it. So a lot of the job and I actually have been the ombudsman for a number of years, and that has helped a lot because a lot of it is guidance, but a lot of it is also options and it's communication. And sometimes I just can help connect people and be this big old bridge to...you

00;23;04;02 - 00;23;34;24
Suzanne Bentley, M.D.
come upset about a problem, right, and your whole department is upset about this because X, y, Z is not happening. But I maybe know either who I can ask or that's already underway. And yes, progress can be slow, but perhaps just giving the update like I hear you. And it's actually, you know, it's happening. That alone, that ability to close the loop, I think is something that we haven't always historically had and that can really magnify well-being without actually doing anything differently.

00;23;34;27 - 00;24;11;19
Suzanne Bentley, M.D.
But again, how do you take in all of the ideas, all of the issues when we're all healers, we're all in this because we want to make everybody feel better. You know, it's got to be a balance. And I think it's something that still I struggle with a lot because there are so many hours in the day and everyone has my personal cell phone number and I cherish that people feel safe being vulnerable with me, you know, But sometimes you run out of time and sanity even to kind of take it all in, because I feel very strongly if I'm going to hear it and I'm going to commit to getting you information or to

00;24;11;22 - 00;24;34;23
Suzanne Bentley, M.D.
helping improve something, that I will do it. You know, so all of a sudden that to do list that was already insurmountable, you know, just becomes kind of frenzied volumes of information. And I don't think I necessarily saw all of that coming just because I've been in roles with tons of people and tons of different opinions. And and I enjoy the challenge of kind of synthesizing all of it.

00;24;34;25 - 00;25;06;26
Suzanne Bentley, M.D.
And now we've worked to a place of putting infrastructure into record it, to delegate it, to have accountability, people assigned so that it's not all me chasing people. You said you would help this department with X, Y, Z, and that's really helped a lot. But I do think that wellness is everything to all people in all ways, and we're doing a good job of prioritizing what needs to be done first, what needs to be worked on the most as a society of CWOs

00;25;06;26 - 00;25;21;03
Suzanne Bentley, M.D.
but I think there are lots of discussions still around how to kind of put up the boundaries to just make sure that it stays doable and that it's maximally impactful, which is obviously the goal of the role at the end of the day.

00;25;21;05 - 00;25;47;06
Elisa Arespacochaga
Absolutely. I often describe the same with the workforce, which is everything everywhere all at once. So how do you even start your to-do list? So absolutely here you and I think that's a great piece of advice for those looking to step into a role like this. Understand that there will always be another need, but you also you can't care for others if you don't create the space for you.

00;25;47;08 - 00;26;07;13
Suzanne Bentley, M.D.
Part of that is also, I think, a bit of responsibility, you know, before you start asking people the questions, you know, making sure that you both have the ability to take them in and answer them and close the loop, but also that you have the buy-in to truly take them in. And that was discussions I had before I even took the role.

00;26;07;16 - 00;26;31;07
Suzanne Bentley, M.D.
That's really some of the tough conversations with leadership about, you know, we're going to learn things that are not necessarily what we want to hear. I want to hear them because that's how we improve. But, you know, if some of this is, quote, negative or hard to fix, we have to sit with that discomfort and be okay with it and just know that we're not going to be able to fix it all.

00;26;31;09 - 00;26;52;06
Suzanne Bentley, M.D.
But it can be just as powerful reframing again how we're showing up to staff to listen to kind of just partner, to admit even that maybe that isn't something we can fix today, but that we're glad it's shared and we're going to write it down. We're going to look at the themes. We're kind of going to validate it, but not just with lip service.

00;26;52;09 - 00;27;15;26
Suzanne Bentley, M.D.
And that was another big not lesson learned but thing I think thankfully I had gotten good advice around before I even stepped into the role because there's a lot of buy in for the end point. But the process is messy, right? Because these are humans. You don't know what you're getting. You have no idea what adversity you're about to try to get 6,000, 10,000, however many employees through

00;27;15;28 - 00;27;37;29
Suzanne Bentley, M.D.
you know, with COVID, I think being the most powerful example. So you have to want that end goal, but you have to also really commit to kind of muddling through together and just collaborating and partnering and iteratively improving. And in doing the baby steps really to get to the end goal, which is obviously, you know, moving the needle on people, being more well.

00;27;38;01 - 00;28;01;03
Elisa Arespacochaga
Well, thank you, Dr. Bentley. I so appreciate you sharing your lessons learned, your enthusiasm, which comes straight through the screen. And I can feel how excited you are about this program and the work that you get to do. And I just really want to thank you for all your contributions to both locally and then to the field in helping others understand how to do this work effectively.

00;28;01;05 - 00;28;04;12
Suzanne Bentley, M.D.
Thank you. It's wonderful chatting with you. Thank you again for having me.